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Medical Benefits |
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Insured
persons and their dependants are entitled to full
medical care from day one of taking up employment
in any factory or establishment covered under the
ESI Act 1948. The comprehensive package includes
primary medical care, specialists and diagnostic
services, in-patient care with provision for all
super specialist facilities.
The scheme provides full range of medical care,
namely;
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Out-Patient services |
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Diagnostic services |
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Specialists services |
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Hospital service through a
network of ESI dispensaries & Panel clinics,
diagnostic centers and ESI Hospitals.etc |
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The package covers all aspects of health care from
primary to super-specialist facilities as detailed
below:- |
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Out patient treatment |
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Domiciliary treatment |
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Super-speciality treatment |
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Specialist consultation and
diagnostic facilities |
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In-Patient treatment |
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Free supply of drugs and
dressings. |
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X-ray and laboratory
investigations |
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Vaccination and preventive
inoculations |
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Ante-natal care, confinement
and post natal care |
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Ambulance Service or conveyance
charges for going to hospitals, diagnostic
centers, etc. wherever admissible |
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Free diet during admission in
hospitals |
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Free supply of artificial
limbs, aids and appliances for physical
rehabilitation |
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Family welfare services and
other national health programe services |
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Medical certification |
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Special provisions including
super-speciality treatment. |
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For super-speciality treatment such as |
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Open Heart Surgery, Neuro
Surgery, Bone Marrow Transplant, Kidney
Transplant or specialized investigations like
CAT scan, MRI, Angiography etc. |
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Referral arrangements have been
made with the reputed , premier hospitals of
the country. The total cost of such treatment,
diagnostic facilities or surgical intervention
is borne by the ESI Scheme. |
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Though medical care is
provided, by and large, to the beneficiaries
in modern system of medicine (Allopathic),
facilities in indigenous systems such as (i)
Ayurveda (ii) Unani (iii) Homoeopathy & Siddha
are also being provided to the insured
persons, on demand in many areas |
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Extension of medical cover to the Retired and
Disabled Insured Persons and their spouses
(Rule 60 & 61 of ESI Central Rules - 1950). |
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The scheme also provides for a
comprehensive medical cover to the retired and
disabled insured persons and their spouses on
pre-payment of a nominal contribution of
Rs.120/- per annum, per couple, provided that
the insured person was in continuous insurable
employment for at least 5 years before
retirement. The scheme, thus, offers total
medical cover to the retired and disabled
employees without any upper ceiling on
expenditure at a very low premium when
compared with medical cover schemes introduced
by some other insurance agencies in the
business of medical insurance.
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